Dozens of health professionals, including doctors, nurses and paramedics, are dying of fatal drug overdoses every year, and some of them are using drugs found in their workplaces.

There were 404 fatal drug overdoses among health professionals between 2003 and 2013, with an average of 37 each year, a study of coronial investigations has found.

Nurses – particularly females – dominate the group, accounting for 63 per cent of the deaths. They were followed by mostly male doctors, who made up 18 per cent of the deaths. The remaining groups were psychologists, paramedics, physiotherapists, pharmacists, dentists, and veterinarians.

While half of the deaths were documented as intentional, 38 per cent were unintentional. The researchers said the latter was “alarming given that health care professionals are presumably highly skilled in the appropriate administration of drugs, but made fatal errors in self-administration”.

The drugs most commonly used were antidepressants, antipsychotics, benzodiazepines, and opioids such as morphine and fentanyl. Alcohol was the primary cause of death in 15 per cent of cases.

However, there were some trends within the professional groups. Anaesthetics were commonly used by doctors, particularly propofol among anaesthetists, and many veterinarians took drugs they use to put animals down.

It is unclear how many had been abusing drugs on the job, however they were all employed at the time of their death. Six of the 72 doctors in the study were either temporarily suspended or under review by the Medical Board.

Only 4 per cent or 16 out of the 404 people had previously been diagnosed with a substance abuse problem. In 18 per cent of cases, drugs had been stolen from the workplace or obtained through self-prescription. These drugs were most commonly anaesthetics or opioid painkillers.

There is no reliable research estimating how many Australian health professionals are dependent or addicted to drugs, but American research suggests one in 14 doctors actively abuse drugs.

Lead researcher Jennifer Pilgrim, of the Victorian Institute of Forensic Medicine, said when she read through the coroner’s notes on the deaths, about half had been diagnosed with a mental illness, most commonly depression or anxiety.

The notes revealed about one in three had obvious stresses in their lives at the time of their death, such as relationship, work, or financial problems, or grief over the death of a family member or friend.

A report on the study published in the journal Addiction, called for more debate about improving the detection and management of drug addicted and impaired health professionals.

It said while intoxication on duty was rare, some researchers advocated random drug testing of health professionals, particularly after an unexpected medical event that results in a patient’s injury or death. Other researchers favoured a rehabilitation approach that encouraged people to seek help.

Medical director of the Victorian Doctors’ Health Program Kym Jenkins said she favoured a rehabilitation approach because it had a high success rate for doctors when they decide they wanted to recover from addiction.

“Doctors tend to be perfectionists so once they decide to get better, they get better,” the psychiatrist said.

Dr Jenkins said a lot of work was being done to improve mental health services for health professionals who find it hard to seek help.

If you are troubled by this report you can call Lifeline 131 114 or beyondblue 1300 224 636.

This piece by Julia Medew was first seen on the ‘The Age’ on November 22, 2016.